6533b874fe1ef96bd12d63fb

RESEARCH PRODUCT

Economic impact of mepolizumab in uncontrolled severe eosinophilic asthma, in real life

Diego BagnascoMassimiliano PoveroLorenzo PradelliLuisa BrussinoGiovanni RollaMarco CaminatiFrancesco MenzellaEnrico HefflerGiorgio Walter CanonicaPierluigi PaggiaroGianenrico SennaManlio MilaneseCarlo LombardiCaterina BuccaAndrea ManfrediFrank Rikki CanevariGiovanni PassalacquaGabriella GuarnieriVincenzo PatellaFoschino Barbaro Maria PiaElisiana CarpagnanoAnna Del ColleGiulia SciosciaPelaia GerolamoPierluigi PaggiaroManuela LatorreFrancesca PuggioniFrancesca RaccaElisabetta FaveroSandra IannaconeEleonora SaviMarcello MontagniGianna CamiciottoliChiara AllegriniGiuseppe SpadaroCaterina DetorakiCarla GaleonePatrizia RuggieroMona-rita YacoubAlvise BertiGisella ColomboNicola ScichiloneCarmen DuranteMaria Teresa CostantinoChiara RoncalloMariachiara BraschiFrancesco BlasiAlice D'addaErminia RidoloMassimo TriggianiRoberta ParenteD'amato MariaMaria Vittoria VerrilloZappa Maria CristinaMarianna LilliNunzio CrimiMarco BonaviaAngelo Guido CorsicoAmelia GrossoStefano Del GiaccoMargherita DeiddaLuisa RicciardiStefania IsolaFrancesca CiceroGiuliana AmatoFederica VitaAntonio SpanevelloPatrizia PignattiFrancesca CherubinoDina ViscaEleonora AlettiFabio Luigi Massimo RicciardoloVitina Maria Anna CarrieroFrancesca BertoliniPierachille SantusRoberta BarlassinaAndrea AiroldiGiuseppe GuidaNucera EleonoraArianna AruannoAngela RizziCristiano CarusoStefania ColantuonoAlessandra ArcolaciAndrea VianelloFulvia Chieco BianchiMaria Rita MarchiStefano CentanniSimone LuraschiSilvia RuggeriRocco RinaldoElena ParazziniCecilia CalabreseMartina FloraLorenzo CosmiLinda Di PietroEnrico MaggiLaura PiniLuigi MacchiaDanilo Di BonaLuca RicheldiCarola CondoluciLeonello FusoMatteo BoniniAlessandro FarsiGiulia CarliPaolo MontuschiGiuseppe SantiniMaria Elisabetta ConteElisa TurchetCarlo BarbettaFrancesco MazzaSimona D'aloStefano PucciMaria Filomena CaiaffaElena MinennaLuciana D'eliaCarlo PasculliVittorio VivianoPaolo TarsiaJoyce RoloMariacarmela Di ProiettoSalvatore Lo CiceroMariacarmela Di Proietto

subject

OR Odds RatioPediatricsSevere asthmaExacerbationAnti IL-5; Comorbidities; Mepolizumab; OCS; Pharmacoeconomics; Severe asthmagastroesophageal reflux diseaseSettore MED/10 - MALATTIE DELL'APPARATO RESPIRATORIOICS inhaled corticosteroidRate ratioOCS Oral Corticosteroidslaw.inventionComorbiditiesLAMA long acting muscarinic antagonist0302 clinical medicineRandomized controlled trialfractional nitric oxideInterquartile rangelawlong acting beta 2 agonistOdds RatioImmunology and AllergyRR Rate Ratio030223 otorhinolaryngologyPharmacoeconomicLOS Length of stayLOSIQRLAMAMEP MepolizumabORCISD Standard DeviationMEPPharmacoeconomicsACT Asthma Control TestComorbiditieCI Confidence Intervalsmedicine.druglcsh:Immunologic diseases. AllergyPulmonary and Respiratory Medicinemedicine.medical_specialtyinterquartile rangelong acting muscarinic antagonistImmunologyLABALABA long acting beta 2 agonistComorbidities Mepolizumab OCS Pharmacoeconomics Severe asthma Anti IL-5RRArticleRate Ratiochronic obstructive pulmonary disease03 medical and health sciencesPharmacoeconomicsOCS Oral CorticosteroidAsthma Control TestConfidence IntervalsFeNO fractional nitric oxideRCTs Randomized Controlled TrialmedicineCOPDGERD gastroesophageal reflux diseaseFeNOIQR interquartile rangeMepolizumabSDAsthmaRCTsOral Corticosteroidsbusiness.industryGERDmedicine.diseaseICS inhaled corticosteroidsACTComorbidityRandomized Controlled TrialsCI Confidence IntervalRCTs Randomized Controlled TrialsOCSCOPD chronic obstructive pulmonary disease030228 respiratory systemICSStandard DeviationLength of stayAnti IL-5inhaled corticosteroidslcsh:RC581-607businessMepolizumab

description

Abstract Background and aims Severe asthma is burdened by frequent exacerbations and use of oral corticosteroids (OCS) which worsen patients’ health and increase healthcare spending. Aim of this study was to assess the clinical and economic effect of adding mepolizumab (MEP) for the treatment of these patients. Methods Patients >18 years old, referred to 8 asthma clinics, starting MEP between May 2017 and December 2018, were enrolled and followed-up for 12 months. Information in the 12 months before mepolizumab were collected retrospectively. The evaluation parameters included: OCS use, number of exacerbations/hospitalizations, concomitant therapies, comorbidity, and annual number of working days lost due to the disease. The primary objective was to compare the annual total cost per patient pre- and post-MEP. Secondary outcomes included rates of exacerbations and number of OCS-dependent patients. Results 106 patients were enrolled in the study: 46 male, median age 58 years. Mean annual cost pre- and post-MEP (cost of biologic excluded) was €3996 and €1,527, respectively. Total savings due to MEP resulted in €2469 (95%CI 1945–2993), 62% due to exacerbations reduction and 33% due to productivity increase. Such savings could fund about 22% of the total cost of MEP for one year. The introduction of MEP induced a clinical benefit by reducing both OCS-dependent patients (OR = 0.12, 95%CI 0.06–0.23) and exacerbation rate (RR = 0.19, 95%CI 0.15–0.24). Conclusions Patients with severe eosinophilic asthma experienced a clinical benefit in asthma control adding MEP to standard therapy. Biologic therapy can be, partially, funded by the savings produced by patients’ improvement.

yearjournalcountryeditionlanguage
2021-02-01
10.1016/j.waojou.2021.100509https://hdl.handle.net/11567/1039731